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Individual

DR. MIGUEL R HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1030 W GORDON AVE, STE A, ALBANY, GA 31701-4514
(229) 432-9555
Mailing address
1030 W GORDON AVE, STE. A, ALBANY, GA 31701-4514
(229) 432-9555
(229) 432-0907

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5273
AL
1223G0001X
General Practice Dentistry
Primary
DN013292
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009927125
AL
05
009933951
AL
05
009935939
AL
05
009976865
AL
05
129513623A
GA
Enumeration date
08/31/2006
Last updated
09/08/2011
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